Job information

  Job Activity Description: Install/Dismentle Scaffolding dalam tanki Date:

Work-order number: ZULU/007/TK/ Job Requestor: DODY R.M Work area:

Company: PT. PILAREN

Error Traps: (Check all that apply)

( ) Time Pressure, Stress, High Work load ( ) End of Shift or Work Cycle ( ) First time/Infrequent task ( ) Poor Verbal Communication
( ) Distractions ( ) First Day Back > 4 days ( ) Vague/poor work guidance ( ) Over-Confidence
( ) Simultaneous Tasks/Work in Vicinity ( ) Line of Fire
Social Distancing Considerations and Requirements
When work plan calls for individuals to be closer than 6ft (2m) from each other for longer than 15 min, the following requirements should be applied:
( ) Respiratory protection must be worn (facial covering) ( ) Must have a plan to minimize time within 6ft of each other
( ) Face and Eye protection shall be selected and available (glasses, goggles, face shield) ( ) Ensure that all participants are not symptomatic (no cough, fever, shortness of breath, or feeling ill)
( ) Hand and body protection must be selected and available (nitrile gloves, Tyvek suit, etc.) ( ) Post sanitation of equipment and tools as well as doffing plan created
During work, considerations must be taken to limit the potential spread of diseases. Hands should be washed pre & post task. It is also recommended whenever you leave the work zone
Step 1: Describe the job steps Step 2: Identify the Hazards of the Job Step in the field Step 3: Control Measures
1. Persiapan izin kerja dan PJHA 1.1. Tidak ada izin pekerjaan di stop 1.1.1. Pastikan izin kerja sudah divalidasi
1.2. Kesalahan dalam analisa bahaya 1.2.1. Pembuatan PJHA melibatkan tim EHS dan Supervesior

2. Persiapan personil 2.1. Personil dalam keadaan tidak fit 2.1.1. Pastikan personil dalam keadaan fit untuk bekerja di
ketinggian

3. Persiapan alat / matrial 3.1. Lowback pain 3.1.1. Pekerja sudah terlatih manual handling
3.2. Alat / matrial jatuh 3.2.1. Ikat kunci dengan tali / lanyard
3.2.2. Jika diperlukan, gunakan alat bantu pully dan ikat dengan
benar

Is there any LIFEsaver or SIF precursor involved? ( ) No (Tier 1 - Move to step 8)  ( )
( ) Barge/Ship Operation
( ) Equipment Failure
( ) Machine/Conveyor Guarding
( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Mining Operation
Motor Vehicle Working at Lockout Tagout Mobile Ralicar Safety Electrical Work Hazardous Bulk Material Confined Excavation and Hot Work Lifting and ( ) Animal/Biological
Traffic Safety Height Equipment Materiais Handling/ Space Entry Trench Work Rigging
Storage ( ) Other
Is a PtW (Permit to Work) needed or any other additional check list? ( ) Yes ( ) No
If Yes, what are they?
Step 4: Define task specifics STOP criteria Step 5: What is the worst case scenario and its Step 6: Emergency preparedness Step 7: Quality Review
consequences?
1. APD tidak standart 1.1 Sesak nafas karna kurangannya sirkulasi udara 1.1.1. Stop pekerjaan, evakuasi korban ketempat
dalam tanki aman, siapkan oksigen portable, lakukan
perawatan oleh tim paramedic. Larikan
kerumah sakit / klinik terdekat jika diperlukan
1.2. Terpeleset, tergores 1.2.1. Siapkan P3K, lakukan pertolongan pertama
Cargill Representative Quality Review
2. Dipasang oleh orang tidak kompetent 2.1. Terjatuh saat install scaffolding 2.1.1. Evakuasi korban, lakukan perawatan oleh tim ( )
paramedic

3. Perancah tidak standart 3.1. Scaffolding roboh 3.1.1. Lakukan evakuasi, dan berikan perawatan
oleh tim paramedic

4. Tangga akses tidak standart 4.1. Tertimpa tangga 4.1.1. Siapkan P3K, lakukan pertolangan pertama
Employees working in the area have
5. Kurangnya pencahayaan dalam tanki 5.1. Tersandung, tergores 5.1.1. Siapkan P3K, lakukan pertolongan pertama been notified of this work?

Yes No
( ) ( )
Step 8: Workers accepting PJHA, and will work according the identified herein:
Task Leader: Name: Name:

Name: Name: Name:

Teams quickly debrief the task they planned and consider anything that they missed, would change, or even assumed correctly after the task is complete:
( ) Yes ( ) No

( ) 2nd shift Revalidation ( ) 3rd shift Revalidation ( ) 4th shift Revalidation ( ) 5th shift Revalidation
Have tools and equipment used during the
__/__/____ __/__/____ __/__/____ __/__/____
task been removed and accounted for as well
as the area being cleaned and debris Starts at: Starts at: Starts at: Starts at:
removed upon completion? Finishes at: Finishes at: Finishes at: Finishes at:
( ) Yes ( ) No Cargill Rep.: Cargill Rep.: Cargill Rep.: Cargill Rep.:
Task Team Lead: Task Team Lead: Task Team Lead: Task Team Lead:
 If additional steps. Hazards and controls are needed for the task, use the area below labeled Annex

Step 1: Describe the job steps Step 2: Identify the Hazards of the Job Step in the field Step 3: Control Measures

1. Memindahkan matrial dengan manual handling 1.1. Cidera otot 1.1.1. Gunakan alat bantu pully jika diperlukan
1.1.2. Gunakan sarung tangan
1.1.3. Dilakukan oleh kompetent persons
1.1.4. Komunikasi yang baik antar pekerja

2. Install / dismentle scaffollding dalam tanki 2.1. Sesak nafas / terhidup gas beracun 2.1.1. Lakukan gastest sebelum masuk kearea dalam tanki
2.1.2. Pastikan blower, attendent, sign dan gas detector standby
2.1.3. Entrant masuk kedalam tanki dengan membawa PGD
2.1.4. Lakukan pengecekan 30-60 menit secara berkala
dengan gas detector dan jalankan control bord
2.1.5. In/out entrant max 30menit

2.2. Alat / matrial jatuh dari atas 2.2.1. Ikat kunci dengan tali / lanyard
2.2.2. Pastikan asiba terikat
2.3. Terjatuh dari ketinggian 2.3.1. Posisi pekerja saat memasang harus berada didalam
handrail / lifeline
2.3.2. Gunakan FBH, kaitkan 100% keachor point
2.3.3. Pastikan FBH dicek terlebih dahulu sebelum digunakan
2.4. Scaffolding kolabs 2.4.1. Kekuatan scaffolding sesuai kegunaan
2.4.2. Scaffolding diinstall pada tapak yang rata / kuat
2.4.3. Pastikan scaffolding tidak miring
2.4.4. Pastikan dicek oleh kompetent persons dan
diberi green tag
2.4.5. Pastikan dipasang oleh kompetent persons
2.5. Pekerjaan bersinggungan dengan kontraktor lain 2.5.1. Lakukan koordinasi dengan kontraktor lain
2.5.2. Baricade area kerja dan diberi sign
2.6. Perbedaan level 2.6.1. Pastikan dilakukan oleh kompetent persons dan ditandai
dengan arm band

3. Housekeeping 3.1. Tersandung matrial scaffolding yang berantakan 3.1.1. Rapihkan matrial scaffolding yang belum digunakan
dan diberi baricade
3.1.2. Segera pindahkan matrial yang sudah tidak terpakai
diarea kerja

Step 7: Quality Review

Employees working in the area have been notified of this work?
Cargill Representative Quality Review
(Name)
( ) Yes ( ) No
Step 8: Workers accepting PJHA, and will work according the identified herein
Task Name: Name:
Leader:

Name: Name: Name:

Name: Name: Name:

Name: Name: Name:

Name: Name: Name:

Is a PtW needed or any other additional check list? ( ) Yes ( ) No

If Yes, what are they?

Teams quickly debrief the task they planned and consider anything that they missed, would change, or even assumed correctly after the task is complete:
( ) Yes ( ) No

Have tools and equipment used during the ( ) 2nd shift Revalidation ( ) 3rd shift Revalidation ( ) 4th shift Revalidation ( ) 5th shift Revalidation
task been removed and accounted for as well __/__/____ __/__/____ __/__/____ __/__/____
as the area being cleaned and debris Starts at: Starts at: Starts at: Starts at:
removed upon completion? Finishes at: Finishes at: Finishes at: Finishes at:
( ) Yes ( ) No Cargill Rep.: Cargill Rep.: Cargill Rep.: Cargill Rep.: